I thought I'd share my story as I think it's interesting and obviously I would like some advice. If Jeff has any general thoughts in particular that would be good (huge fan of McDougall and Jeff Novick, and thanks for everything they've done to help global health).
History
• History of HBP for at least 11 years, more likely 15 years since 2008. Consistently over 140/150 systolic and 80-95 diastolic. First reading Jan 2012.
• Panic disorder since Sept 2008, symptomatic between Sept 2008 - Jan 2012 having regular panic attacks, treated with beta-blockers during 2010-2011. No panic attacks since Jan 2012, but generally nervous person and possibly still existing but asymptomatic (no major panic attacks).
• Weighed around 13 stone, was running, lifting weights and extremely fit during 2008-2012 when blood pressure was first measured high. I'm 6"1 with a BMI of 24 at the time, now it's more like 33.
• Past drug use (C) since 2007 when 18 years old, throughout late teens and early 20s, around 10-20 times per year 1-2 grams per use. Since late 20s only a handful to a couple of times per year. Last time took C was Sept 2022, prior was Jan 2022.
• Began putting on weight in 2017 after knee cartilage injury (prior weighed around 13 stone, now 18 stone), felt depressed and ate too much higher fat vegan foods/Indian takeaways and too much refined sugar, although still ate a significant amount of WFPB.
• WFPB partially since 2011, less strict between 2017-2021 where I ate too many vegan high-fat takeaways. Strict since Dec 2022, including removal of all nuts and peanut butters/tahini etc and even stricter on oil use (which was only found significantly in my takeaways, didn't cook with oil other than 1 cal spray). No significant consumption of animal foods (and thus cholesterol), or fried foods, since 2011.
• No home BP monitor, but plan to buy one soon. All readings taken in a doctors/nurses office.
• Highest BP reading was 181 systolic recently during a stressful event in AandE.
• Never medicated for HBP, do not take any medicines for anything.
• Smoking? Never
• Alcohol? 1-5 pints of lager per month (very little, in my teens and early 20s a lot more, but not for years have I significantly drank alcohol).
• Caffeine? Stopped completely in early December 2022, prior I drank 1 can of Coke Zero (which is caffeinated) and 1-2 decaf tea per day (which has caffeine in it). Now I've moved to chicory/barleycup and balsamic vinegar/club soda which have 0 caffeine.
• Drugs? Yes, C very occasionally, now down to 1-2 times per year on occasional social events (last time took was September 2022, and the January of that year).
• Oils? Very limited, only a small amount of 1 cal spray to line the pan for wedges/hash browns, tiny amounts in microwave rice and on dates/raisins, occasional breads that have it in and occasionally in vegetarian takeaway food. Overall I would consider it very low oil compared to the general population.
• Animal foods? Extremely rarely, 1-4 times per year, i.e butter accidentally on bread, a piece of fish on holiday. Never consume them regularly and can't remember the last time I ate them knowingly.
• Typical daily meals?
Breakfast: porridge with dates, cinnamon, raisins, frozen berries, brown sugar and water/soy milk.
Lunch: Large 4 banana smoothie with oats, frozen berries, spinach, mango, soy milk, ice and water OR potato wedges/hash browns cooked in a pan with 1 cal spray with microwaved veg and BBQ or Mustard sauce.
Dinner: beans over rice, black/kidney/pinto beans blended with garlic and spices/sugar with salsa/hot sauce OR bean burrito/burger OR homemade hummus (two cans) of chickpeas blended with tahini and peanut butter, garlic, lemon juice with no-oil wholegrain pitta bread.
I also occasionally have a bowl of cold cereal like cornflakes, soy milk and sugar or rolled oats with dates etc with soy milk before bed (not ideal for weight loss I know).
Lipid panel
As part of my annual medical (this is the first I've ever done one) and because they are aware of my HBP, my GP has provided a full lipid panel today (although it was a non-fasting lipid panel) which I have shared in images in this post. It does not provide an LDL value, but McDougall says the total is what matters anyway for cholesterol.
• Total cholesterol: 3.9 mmol/L (150.8 mg/dL)
• HDL: 0.99 mmol/L (38.28 mg/dL)
• Non-HDL: 2.9 mmol/L (112.14 mg/dL)
• Cholesterol/HDL ratio: 3.9
• Triglycerides: 2.8 mmol/L (248mg/dL)
• HbA1c level: 30 mmol/mol (4.9)
***LDL was not provided as non-fasting test.
Possible remedies
I've been considering going on either a water fast or an elimination diet to discover IF it is the diet that's causing it (or how much the diet is contributing). On a water fast for say 1-2 days, check how low the BP goes, and then add in food (and salt) to see how it affects blood pressure. Or do an elimination diet and begin with say white potatoes or white rice, and then add in food to see how it affects it. I currently don't have a BP checker but I can buy one soon.
As Dr Essylstyn has mentioned about building blocks, we only have a limited ability to change our behaviour and habits, and I am nearly at that limit having changed so much although plant-based eating is totally normal for me now (I don't miss animal foods). Stopping all caffeine, alcohol, drugs, takeaways, animal foods, and cooking all the time, limiting salt etc is not an easy task. If all this doesn't work on my blood pressure, then I will probably just live with the risk and accept it. I doubt I'll medicate as there are too many bad side effects.
My liver also has a slight elevation in ALT (44 U/L) and albumin (51 g/L), which may be related to the high trigs (and sugar/fat amounts). I don't consume alcohol regularly so doubt it is that.
Questions (does anyone want to have a guess?)
1) If you were to guess, would you think it's more likely my HBP is being caused by the panic disorder (or past drug use) OR by my diet?
2) What is likely causing the High Triglycerides given my circumstances?
3) Am I at risk of heart disease/CVD if my cholesterol is in healthy/normal ranges BUT my blood pressure and/or trigs are high (i.e am I "good" with my total cholesterol or should I be concerned by the HBP and trigs)?
4) Am I likely to get a major CVD event with permanently elevated blood pressure if I don't somehow lower it to below 140/150 systolic?
5) If my total cholesterol was now 150, would it have taken a long time for it to get this low, or could it have arrived here from a much higher value since December 2022 (i.e. could it have been say 220 in December, then drop to this in 4 months going strict WFPB)?
UPDATE 05/05/23
I appreciate my post was probably too long so I have condensed it, I just tried to give all the info I could.
This post from Brand New Vegan (https://www.brandnewvegan.com/articles/ ... pb-journey) where he documents his wife's HBP and lowered it dramatically on an extremely strict minimalist WFPB diet has given me hope that I can lower it by going even stricter - although she is taking HBP medication I think.
Any thoughts are welcomed, and sorry for the long post, Dave
